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Increased levels of interleukin 5 are associated with the generation of eosinophilia in drug‐induced hypersensitivity syndrome
Author(s) -
Geneviève Choquet-Kastylevsky,
L Intrator,
C Chenal,
Hélène Bocquet,
Jean Revuz,
J Roujeau
Publication year - 1998
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1046/j.1365-2133.1998.02559.x
Subject(s) - eosinophilia , medicine , interleukin 5 , drug , interleukin , immunology , interleukin 2 , dermatology , pharmacology , cytokine
Hypersensitivity syndrome (HSS) usually refers to severe drug eruption associated with systemic symptoms and eosinophilia. Interleukin (IL)‐5 regulates eosinophil counts with the help of IL‐3 and granulocyte‐macrophage colony‐stimulating factor (GM‐CSF). Blood IL‐5 levels have been reported to be increased in patients with eosinophilia secondary to parasitic infections or idiopathic eosinophilia, but have never been evaluated in drug‐induced eosinophilia. The aim of our study was to determine whether IL‐5, IL‐3 and GM‐CSF are involved in eosinophilia in patients with drug‐induced HSS. Plasma levels of IL‐3, IL‐5 and GM‐CSF were assayed by ELISA in seven patients with drug‐induced HSS, in eight patients with cutaneous adverse drug reactions not associated with eosinophilia, and in five patients with eosinophilia unrelated to drug treatment. IL‐5 levels were normal in all eight patients with drug eruptions without eosinophilia, and increased in five of the seven patients with HSS. In the latter patients, IL‐5 levels peaked several days before highest eosinophil counts were noted, and returned to normal within a few days, even when eosinophilia persisted. In patients with eosinophilia unrelated to drug treatment, IL‐5 levels, although significantly increased, remained lower than in HSS patients. IL‐3 and GM‐CSF could not be detected in any group, at any time. Our results show that IL‐5 is involved in drug‐related eosinophilia. As IL‐5 production was only involved in the early stages of the reaction, it is suggested that IL‐5 mainly derives from activated lymphocytes rather than eosinophils. Our results support the clinical relevance of previous in vitro findings. Further studies are needed to test whether assays of IL‐5 production by lymphocytes of patients stimulated by the suspected drug and/or its metabolites, are useful in establishing causality in drug‐induced reactions associated with eosinophilia.